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Doc code: Oath Document Description: Oath or declaration filed PTO/SB/107 (05-16) Approved for use through 04/30/2017. OMB 0651-0032 U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number. ( , 37, § 1.63) DECLARATION FOR UTILITY OR DESIGN PATENT APPLICATION (37 CFR 1.63) Attorney Docket Number First Named Inventor , COMPLETE IF KNOWN Application Number ( ( Art Unit Declaration Submitted With Initial Filing OR , 37, § 1.16(f)) Declaration Submitted After Initial Filing (surcharge (37 CFR 1.16(f)) required) Filing Date Examiner Name , ( ), () , ( ) ( ), , : I hereby declare that: (1) Each inventor's residence, mailing address, and citizenship are as stated below next to their name; and (2) I believe the inventor(s) named below to be the original and first inventor(s) of the subject matter which is claimed and for which a patent is sought on the invention titled: , : 1) , ; 2) , (Title of the Invention) the application of which was made or was authorized to be made by me and is attached hereto OR ( / / ) ( was filed on (MM/DD/YYYY) / / ) ( ). as United States Application Number or PCT International Application Number (if applicable). , , . and was amended on (MM/DD/YYYY) , I hereby state that I have reviewed and understand the contents of the above identified application, including the claims, as amended by any amendment specifically referred to above. , , , . I acknowledge the duty to disclose information which is material to patentability as defined in 37 CFR 1.56, including for continuation-in-part applications, material information which became available between the filing date of the prior application and the national or PCT international filing date of the continuation-in-part application. 37, § 1.56, , [ 1 4] [Page 1 of 4] This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. The information is required to obtain or retain a benefit by the public which is to file (and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 21 minutes to complete, including gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any comments on the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450. If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2. American LegalNet, Inc. www.FormsWorkFlow.com PTO/SB/107 (05-16) Approved for use through 04/30/2017. OMB 0651-0032 U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number. ­ DECLARATION -- Utility or Design Patent Application Claim of Foreign Priority Benefits , (f), 365(b), § 365(a), , , , , . , , , , , , , , , 35, § 119( ) ­ (d) , I hereby claim foreign priority benefits under 35 U.S.C. 119(a)-(d) or (f), or 365(b) of any foreign application(s) for patent, inventor's or plant breeder's rights certificate(s), or 365(a) of any PCT international application which designated at least one country other than the United States of America, listed below and have also identified below, by checking the box, any foreign application for patent, inventor's or plant breeder's rights certificate(s), or any PCT international application having a filing date before that of the application on which priority is claimed. () Prior Foreign Application Number(s) Country Foreign Filing Date (MM/DD/YYYY) Priority Not Claimed ? Certified Copy Attached? YES NO () PTO/SB/02B, . Additional foreign application number(s) are listed on a supplemental priority data sheet PTO/SB/02B attached hereto. [ 2 4] [Page 2 of 4] () () American LegalNet, Inc. www.FormsWorkFlow.com PTO/SB/107 (05-16) Approved for use through 04/30/2017. OMB 0651-0032 U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number. ­ DECLARATION -- Utility or Design Patent Application , , : Direct all Correspondence to: ... Name : The address Associated with Customer Number: OR Correspondence address below Address City Country Telephone State Email Email Zip : WARNING: , « , . 1.14). . , , , , , , 18, § 1001, 18, § 1001, . , , 5 , . , , , , , , , ( PTO-2038 . , , 37, § ». , Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card numbers (other than a check or credit card authorization form PTO-2038 submitted for payment purposes) is never required by the USPTO to support a petition or an application. If this type of personal information is included in documents submitted to the USPTO, petitioners/applicants should consider redacting such personal information from the documents before submitting them to the USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a patent. Furthermore, the record from an abandoned application may also be available to the public if the application is referenced in a published application or an issued patent (see 37 CFR 1.14). Checks and credit card authorization forms PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not publicly available. I hereby declare that all statements made herein of my own knowledge are true and that all statements made on information and belief are believed to be true; and further that these statements were made with the knowledge that willful false statements and the like so made are punishable by fine